MODS 患者外周血单个核细胞内 PPARγ与 NF －κB的表达和关系

Expression and relationship of PPARγand NF -κB in peripheral blood mononuclear cells of multiple organ dysfunction syndrome patients

目的：探讨多器官功能障碍综合征（ MODS）患者外周血单个核细胞（ PBMCs）中过氧化物酶体增殖物激活受体γ（ PPARγ）与核转录因子－κB （ NF－κB）的表达和关系。方法选择我院ICU和急诊科MODS患者60例，分为3组，每组20例，MODS 1组（ APACHEⅡ评分0-10分），MODS 2组（ APACHEⅡ评分11-20分），MODS 3组（ APACHEⅡ评分＞20分）及正常对照组（20例健康对照者）为研究对象。确诊后分别于1、3、6 d取静脉血，采用逆转录聚合酶链反应（ RT－PCR）检测PPARγ、NF－κB的表达与同期正常对照组进行比较分析。结果①正常组PBMCs中PPARγ、NF－κBp65表达量均较少。与正常组比较，MODS 1组PPARγ、NF－κBp65表达均明显增高，随治疗时间推移，PPARγ表达明显增高（ P＜0．05）；而NF－κBp65表达则明显降低（ P＜0．05）。 MODS 2组、MODS 3组PPARγ表达低于正常对照组，随着治疗时间增加，PPARγ明显下降（P＜0．05）；NF－κBp65表达高于正常对照组，随着治疗时间增加，NF－κBp65明显升高（P＜0．05）。②相关结果分析表明，PBMCs中PPARγ与NF－κBp65表达在MODS 1组、MODS 2组、MODS 3组呈负相关性（MODS 1组：r＝－0．726，P＜0．01；MODS 2组：r＝－0．736，P＜0．01；MODS 3组：r＝－0．721，P＜0．01），在正常对照组无明显相关性（r＝0．183，P＞0．05）。结论PPARγ可能通过抑制NF－κB的表达对MODS患者起到保护作用，可作为MODS病情判断重要指标和治疗潜在靶点。

Objective To study the expression and relationship of nuclear factor -kappa B （ NF-κB） and peroxisome proliferators activated receptorγ（ PPARγ） in peripheral blood monouclear cells （ PBMCs） of multiple organ dysfunction syndrome （ MODS） patients.Methods In the emergency department and intensive care unit （ ICU） of our hospital, 60 MODS patients were divided into three groups with 20 cases in each group.They were MODS1 group （ APACHEⅡscore 0-10 points） , MODS 2 groups （APACHEⅡ score 11 -20 points）, MODS 3 groups （APACHEⅡ score〉20 points） and control groups of 20 healthy subjects.Venous blood were sampled 1, 3, 6 d after diagnosis of MODS. Reverse transcriptase -polymerase chain reaction （ RT -PCR ） was used to detect the expression of PPARγ, NF-κB in PBMCs.The expression of PPARγ, NF-κB in the same period were compared between the MODS groups and the healthy control group.Results ①The expression of NF-κBp65 and＆amp;nbsp;PPARγwas low in vehicle control group.In MODS 1 group the expression of PPARγand NF-κBp65 was higher than that in vehicle control group; during the treatment period, PPARγwas significantly increased （P〈0.05）, but the expression of NF-κBp65 was was significantly lowered （P〈0.05）. PPARγexpression in MODS 2 group, MODS 3 group was lower than that in vehicle control group, and its expression was progressively decreased during the treatment （P〈0.05）; in contrast, expression of NF-κBp65 in MODS 2 and MODS 3 group was higher than that in vehicle control group, and its level was progressively increased during the treatment （P〈0.05）.The study revealed a significant negative correlation between NF -κBp65 and PPARγin MODS 1 group, MODS 2 group and MODS 3 group （ MODS 1 group：r=-0.726, P〈0.01; MODS 2 group： r=-0.736, P〈0.01; MODS 3 group：r=-0.721, P〈0.01）.There was no significant correlation in vehicle control group （r=-0.183, P〉0.05）.Conclusion PPARγmay protect the MODS patients by repressing the expression of NF-κB, therefore it can be used as an important indicator and potential target to determine the condition and treatment of MODS.